Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is t...Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is thought to give better symptom relief. However, there are few reports on the therapeutic efficacy in pediatric patients. We retrospectively reviewed the medical records of pediatric patients with chronic spontaneous urticaria (csU) who met the following criteria. They were consulted our outpatient clinic between April 2010 and March 2012;were unsuccessfully treated with H1 antihistamines;and were treated with add-on H2-receptor antagonist (famotidine). In six patients who met the inclusion criteria (mean age 6.1 ± 5.1 years), urticaria activity score was significantly decreased from 4.3 ± 0.8 just before administration of famotidine to 1.3 ± 1.0 on the first outpatient visit within 4 weeks after the first administration of famotidine展开更多
AIM: To compare the therapeutic effects of proton pump inhibitors vs H2 receptor antagonists for upper gastrointestinal bleeding in patients after successful endoscopy.METHODS: We searched the Cochrane library, MEDLIN...AIM: To compare the therapeutic effects of proton pump inhibitors vs H2 receptor antagonists for upper gastrointestinal bleeding in patients after successful endoscopy.METHODS: We searched the Cochrane library, MEDLINE, EMBASE and Pub Med for randomized controlled trials until July 2014 for this study. The risk of bias was evaluated by the Cochrane Collaboration's tool and all of the studies had acceptable quality. The main outcomes included mortality, re-bleeding, received surgery rate, blood transfusion units and hospital stay time. These outcomes were estimated using odds ratios(OR) and mean difference with 95% confidence interval(CI). Rev Man 5.3.3 software and Stata 12.0 software were used for data analyses. RESULTS: Ten randomized controlled trials involving 1283 patients were included in this review; 678 subjects were in the proton pump inhibitors(PPI) group and the remaining 605 subjects were in the H2 receptor antagonists(H2RA) group. The meta-analysis results revealed that after successful endoscopic therapy, compared with H2 RA, PPI therapy had statistically significantly decreased the recurrent bleeding rate(OR = 0.36; 95%CI: 0.25-0.51) and receiving surgery rate(OR = 0.29; 95%CI: 0.09-0.96). There were no statistically significant differences in mortality(OR = 0.46; 95%CI: 0.17-1.23). However, significant heterogeneity was present in both the numbers of patients requiring blood transfusion after treatment [weighted mean difference(WMD),-0.70 unit; 95%CI:-1.64- 0.25] and the time that patients remained hospitalized [WMD,-0.77 d; 95%CI:-1.87- 0.34]. The Begg's test(P = 0.283) and Egger's test(P = 0.339) demonstrated that there was no publication bias in our meta-analysis.CONCLUSION: In patients with upper gastrointestinal bleeding after successful endoscopic therapy, compared with H2 RA, PPI may be a more effective therapy.展开更多
目的系统评价质子泵抑制剂(PPI)与H2受体阻断剂(H2RA)比较预防内镜黏膜下剥离(ESD)术后溃疡出血和促进溃疡愈合的作用及其安全性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trials、CENTRAL、EMbase、Google Sch...目的系统评价质子泵抑制剂(PPI)与H2受体阻断剂(H2RA)比较预防内镜黏膜下剥离(ESD)术后溃疡出血和促进溃疡愈合的作用及其安全性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trials、CENTRAL、EMbase、Google Scholar、VIP、CNKI、CBM和WanFang Data数据库,查找所有比较PPI与H2RA预防ESD后溃疡出血和促进溃疡愈合作用的随机对照试验(RCT),检索时限均为建库至2012年10月26日,同时手检纳入文献的参考文献。按纳入和排除标准由4位研究者独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.1软件进行Meta分析。结果最终纳入6个RCT,共616例患者。Meta分析结果显示:PPI预防ESD后溃疡出血的作用优于H2RA[OR=0.51,95%CI(0.29,0.89),P=0.02],而且疗程为8周时,与H2RA相比,PPI预防ESD后溃疡出血的作用也更明显[OR=0.43,95%CI(0.22,0.82),P=0.01];然而合并组、疗程为4周和8周组中,H2RA和PPI在促进ESD后溃疡愈合作用上均无明显差异[OR=0.85,95%C(I0.39,1.86),P=0.69;OR=1.33,95%C(I0.28,6.27),P=0.72;OR=0.75,95%CI(0.31,1.79),P=0.52]。结论对于预防ESD后溃疡出血,PPI作用明显优于H2RA;但两组促进溃疡愈合的作用无明显差异;推荐临床使用PPI预防ESD后溃疡出血。受纳入研究数量和质量限制,需要开展更多高质量、大样本、多中心的RCT进一步论证其安全性。展开更多
文摘Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is thought to give better symptom relief. However, there are few reports on the therapeutic efficacy in pediatric patients. We retrospectively reviewed the medical records of pediatric patients with chronic spontaneous urticaria (csU) who met the following criteria. They were consulted our outpatient clinic between April 2010 and March 2012;were unsuccessfully treated with H1 antihistamines;and were treated with add-on H2-receptor antagonist (famotidine). In six patients who met the inclusion criteria (mean age 6.1 ± 5.1 years), urticaria activity score was significantly decreased from 4.3 ± 0.8 just before administration of famotidine to 1.3 ± 1.0 on the first outpatient visit within 4 weeks after the first administration of famotidine
基金Supported by National Natural Science Funds of China,No.81102784/H2803the key project in scientific research from ministry of education,No.212032Liaoning Innovative Research Team in University,No.LT2013022
文摘AIM: To compare the therapeutic effects of proton pump inhibitors vs H2 receptor antagonists for upper gastrointestinal bleeding in patients after successful endoscopy.METHODS: We searched the Cochrane library, MEDLINE, EMBASE and Pub Med for randomized controlled trials until July 2014 for this study. The risk of bias was evaluated by the Cochrane Collaboration's tool and all of the studies had acceptable quality. The main outcomes included mortality, re-bleeding, received surgery rate, blood transfusion units and hospital stay time. These outcomes were estimated using odds ratios(OR) and mean difference with 95% confidence interval(CI). Rev Man 5.3.3 software and Stata 12.0 software were used for data analyses. RESULTS: Ten randomized controlled trials involving 1283 patients were included in this review; 678 subjects were in the proton pump inhibitors(PPI) group and the remaining 605 subjects were in the H2 receptor antagonists(H2RA) group. The meta-analysis results revealed that after successful endoscopic therapy, compared with H2 RA, PPI therapy had statistically significantly decreased the recurrent bleeding rate(OR = 0.36; 95%CI: 0.25-0.51) and receiving surgery rate(OR = 0.29; 95%CI: 0.09-0.96). There were no statistically significant differences in mortality(OR = 0.46; 95%CI: 0.17-1.23). However, significant heterogeneity was present in both the numbers of patients requiring blood transfusion after treatment [weighted mean difference(WMD),-0.70 unit; 95%CI:-1.64- 0.25] and the time that patients remained hospitalized [WMD,-0.77 d; 95%CI:-1.87- 0.34]. The Begg's test(P = 0.283) and Egger's test(P = 0.339) demonstrated that there was no publication bias in our meta-analysis.CONCLUSION: In patients with upper gastrointestinal bleeding after successful endoscopic therapy, compared with H2 RA, PPI may be a more effective therapy.
文摘目的系统评价质子泵抑制剂(PPI)与H2受体阻断剂(H2RA)比较预防内镜黏膜下剥离(ESD)术后溃疡出血和促进溃疡愈合的作用及其安全性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trials、CENTRAL、EMbase、Google Scholar、VIP、CNKI、CBM和WanFang Data数据库,查找所有比较PPI与H2RA预防ESD后溃疡出血和促进溃疡愈合作用的随机对照试验(RCT),检索时限均为建库至2012年10月26日,同时手检纳入文献的参考文献。按纳入和排除标准由4位研究者独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.1软件进行Meta分析。结果最终纳入6个RCT,共616例患者。Meta分析结果显示:PPI预防ESD后溃疡出血的作用优于H2RA[OR=0.51,95%CI(0.29,0.89),P=0.02],而且疗程为8周时,与H2RA相比,PPI预防ESD后溃疡出血的作用也更明显[OR=0.43,95%CI(0.22,0.82),P=0.01];然而合并组、疗程为4周和8周组中,H2RA和PPI在促进ESD后溃疡愈合作用上均无明显差异[OR=0.85,95%C(I0.39,1.86),P=0.69;OR=1.33,95%C(I0.28,6.27),P=0.72;OR=0.75,95%CI(0.31,1.79),P=0.52]。结论对于预防ESD后溃疡出血,PPI作用明显优于H2RA;但两组促进溃疡愈合的作用无明显差异;推荐临床使用PPI预防ESD后溃疡出血。受纳入研究数量和质量限制,需要开展更多高质量、大样本、多中心的RCT进一步论证其安全性。
